Pediatric Craniomaxillofacial Fractures: A Review
Facial Plast Surg Clin North Am. 2024 Feb;32(1):1-12. doi: 10.1016/j.fsc.2023.06.008.ABSTRACTPediatric facial fractures constitute a small portion of all facial fractures. The frequency of pediatric facial fractures by location, and mechanism of injury, changes over time associated with craniofacial growth and activity. Pediatric patients have protective anatomic features, such as increased soft tissue, excess adipose tissue, and more flexible bone. Conservative management is often sufficient. Surgical intervention can often be conservative. Follow-up monitoring is valuable for concerns of growth disruption from either the...
Source: The Surgical Clinics of North America - November 19, 2023 Category: Surgery Authors: Sophia Matos Matthew D Johnson Source Type: research

Our Evolution of Approaches to Microtia Reconstruction
This article provides an overview of the evolution of microtia reconstruction through history. Techniques pioneered by microtia surgeons Drs. Radford Tanzer, Burt Brent, Satoru Nagata, and Françoise Firmin will be described along with an additional excerpt on the utilization of porous polyethylene (Medpor; Stryker, USA). The objective for the reader is to be able to summarize approaches of each major reconstructive technique, compare the differences in techniques, and gain an understanding of the advantages and disadvantages of each approach.PMID:37981407 | DOI:10.1016/j.fsc.2023.09.002 (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - November 19, 2023 Category: Surgery Authors: Peiyi Su-Genyk Olivia Quatela Vito Quatela Source Type: research

Nonsyndromic Craniofacial Disorders
We describe the investigation and management of select pediatric craniofacial disorders their recent advances. Positional plagiocephaly: The incidence of positional plagiocephaly has increased since the institution of the "safe to sleep" campaign to reduce sudden infant death syndrome. Positional plagiocephaly may be associated with underlying developmental delay. Nonsyndromic craniosynostosis: Treatment of nonsyndromic craniosynostosis depends on the age of the patient and the suture involved. Pediatric skull lesions: Management of skull lesions depends on histologic diagnosis. Some benign skull lesions are managed conser...
Source: The Surgical Clinics of North America - November 19, 2023 Category: Surgery Authors: Antonia L Watson Ryan Winters Source Type: research

Vascular Lesions
Facial Plast Surg Clin North Am. 2024 Feb;32(1):13-25. doi: 10.1016/j.fsc.2023.09.003. Epub 2023 Oct 21.ABSTRACTVascular lesions impact up to 5% of children and range in clinical impact from minor cutaneous aberrations to large masses impacting both form and function. Vascular lesions may be characterized as tumors or malformations. Establishing a clear diagnosis is imperative to understanding the natural history of a vascular lesion and developing a treatment plan. Medical, surgical, intralesional, and laser therapy are all effective and indicated on a case-by-case basis. There are a number of important surgical considera...
Source: The Surgical Clinics of North America - November 19, 2023 Category: Surgery Authors: Matthew J Urban Edwin F Williams Source Type: research

Syndromic Craniofacial Disorders
This article reviews the most common craniofacial syndromes encountered in clinical practice. Key physical features of each condition are highlighted to aid in accurate recognition and diagnosis. Optimal individualized treatment approaches are discussed.PMID:37981410 | DOI:10.1016/j.fsc.2023.07.002 (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - November 19, 2023 Category: Surgery Authors: Robert J Tibesar Andrew R Scott Source Type: research

Tongue and Mandibular Disorders of the Pediatric Patient
Facial Plast Surg Clin North Am. 2024 Feb;32(1):157-167. doi: 10.1016/j.fsc.2023.08.002. Epub 2023 Oct 29.ABSTRACTRobin sequence, macroglossia, and ankyloglossia are disorders affecting the tongue and mandible in the pediatric population. Each of these can have a significant impact on breathing, feeding, speech, dentition, and craniofacial growth. This review discusses the interdependent and coordinated development of both the tongue and mandible, the functional impacts of these disorders, and appropriate management strategies.PMID:37981411 | DOI:10.1016/j.fsc.2023.08.002 (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - November 19, 2023 Category: Surgery Authors: Adam Blancher Ishwarya Mamidi Lisa Morris Source Type: research

Pediatric Facial Reanimation
Facial Plast Surg Clin North Am. 2024 Feb;32(1):169-180. doi: 10.1016/j.fsc.2023.07.003. Epub 2023 Aug 21.ABSTRACTPediatric facial palsy is rare but severely debilitating and results in profound functional, developmental, psychosocial, and esthetic consequences. Identifying the specific cause of the palsy is important in directing the treatment course. The most common etiologies of pediatric facial palsy are distinct from those of adults. Facial reanimation interventions are targeted to address the zones of the face, with oral/smile rehabilitation the most common region requiring intervention in pediatric patients. Gracili...
Source: The Surgical Clinics of North America - November 19, 2023 Category: Surgery Authors: Stephen P Hadford Dane J Genther Patrick J Byrne Source Type: research

Enhanced Recovery After Surgery Protocols in Craniofacial Surgery
Facial Plast Surg Clin North Am. 2024 Feb;32(1):181-187. doi: 10.1016/j.fsc.2023.07.004. Epub 2023 Aug 23.ABSTRACTEnhanced Recovery after Surgery (ERAS) refers to a patient centered, multidisciplinary team developed pathway aimed at reducing the surgical stress response and facilitating expedited patient postoperative recovery. These protocols have been largely developed in the general surgery literature and have led to vast improvements in the patient experience. ERAS protocols are generally substantiated on 3 phases along the continuum of surgical care: preadmission optimization, intraoperative treatment, and postoperati...
Source: The Surgical Clinics of North America - November 19, 2023 Category: Surgery Authors: Tazheh Kavoosi Anjali Pillai Anindita Rajasekaran Adetokunbo Obayemi Source Type: research

Cleft Lip Repair and Primary and Intermediate Cleft Rhinoplasties
Facial Plast Surg Clin North Am. 2024 Feb;32(1):27-41. doi: 10.1016/j.fsc.2023.08.001. Epub 2023 Sep 27.ABSTRACTThe cleft lip is one of the most common craniofacial abnormalities seen worldwide. The lip and primary rhinoplasty repairs are performed together in a single surgery for patients aged 3 to 6 months. The intermediate rhinoplasty has fallen out of favor due to more advanced approaches at primary rhinoplasty. However, it still plays a role in addressing severe nasal airway obstruction or correcting anatomic differences causing emotional distress from social ridicule. The article reviews the incidence of cleft lip, d...
Source: The Surgical Clinics of North America - November 19, 2023 Category: Surgery Authors: Christine Matthews Lisa Morris Cassidy Woolie Laura T Hetzler Source Type: research

Secondary Cleft Rhinoplasty
Facial Plast Surg Clin North Am. 2024 Feb;32(1):43-54. doi: 10.1016/j.fsc.2023.06.003. Epub 2023 Jul 26.ABSTRACTSecondary cleft rhinoplasty remains a challenging operation that requires an understanding of the aberrant anatomy in cleft lip nasal deformity as well as the ability to adapt various techniques suited to the needs of each patient. In this article, we review some of the classically described approaches in cleft rhinoplasty and different strategies to address the nasal subunits. Presurgical adjuncts, surgical interventions before facial skeletal maturity, and patient reported outcome measures are also discussed.PM...
Source: The Surgical Clinics of North America - November 19, 2023 Category: Surgery Authors: David Liao Nicola Pereira Adetokunbo Obayemi Anthony P Sclafani Source Type: research

Primary Cleft Palate Repair
Facial Plast Surg Clin North Am. 2024 Feb;32(1):55-62. doi: 10.1016/j.fsc.2023.07.001. Epub 2023 Aug 12.ABSTRACTThere are several factors to consider when planning cleft palate repair. It is important to review the patient's associated comorbidities, as they impact decisions on perioperative management and family counseling. Many comorbidities change the risk of postoperative airway obstruction, velopharyngeal insufficiency, or fistula formation. It is also critical to determine the type of cleft palate to be addressed, as this influences the decision on which technique is most appropriate for optimal patient outcome. Comm...
Source: The Surgical Clinics of North America - November 19, 2023 Category: Surgery Authors: Barry Daniel Long Rajanya Shah Petersson Source Type: research

Revision Palate Surgery
This article aims to review the current literature on the management of VPI and oronasal fistulae following cleft palate surgery and additionally highlight the role of alveolar bone grafting to improve outcomes for these patients.PMID:37981417 | DOI:10.1016/j.fsc.2023.05.003 (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - November 19, 2023 Category: Surgery Authors: Neal Deot Sherard Austin Tatum Source Type: research

Surgical Management of Velopharyngeal Dysfunction
Facial Plast Surg Clin North Am. 2024 Feb;32(1):69-83. doi: 10.1016/j.fsc.2023.06.007. Epub 2023 Aug 9.ABSTRACTVelopharyngeal dysfunction (VPD) is caused by inadequate closure of the velopharyngeal port. VPD can hinder a child's ability to communicate and can impact his/her quality of life. Evaluation of children with VPD is often completed in a multidisciplinary setting and often involves studies that allow for the visualization of the velopharyngeal closure during voluntary speech (ie, nasopharyngoscopy). Multiple surgical options exist for the treatment of VPD including pharyngeal flap, sphincter pharyngoplasty, buccal ...
Source: The Surgical Clinics of North America - November 19, 2023 Category: Surgery Authors: Jill Arganbright Source Type: research

Pediatric Facial Soft Tissue Repair and Reconstruction
Facial Plast Surg Clin North Am. 2024 Feb;32(1):85-94. doi: 10.1016/j.fsc.2023.07.007. Epub 2023 Oct 28.ABSTRACTThere are unique considerations for the management, repair, and reconstruction of pediatric facial soft tissue injuries. Conventional methods for the repair and reconstruction of facial soft tissue injuries can be successfully applied in children with considerations for anatomic and physiologic differences and the growth potential of a child. Attention to correct form, framework, and esthetics guides the proper reconstruction of individual regions on the face. Choice of approach ultimately depends on and the size...
Source: The Surgical Clinics of North America - November 19, 2023 Category: Surgery Authors: Joshua C Demke Kolos K Nagy Source Type: research

Pediatric Otoplasty and Auricular Molding
Facial Plast Surg Clin North Am. 2024 Feb;32(1):95-103. doi: 10.1016/j.fsc.2023.07.006.ABSTRACTWith the advent of widespread use of commercial ear molding products, the literature addressing the indications for and timing of perinatal intervention in auricular deformations and malformations has increased significantly. Although the rationale for perinatal ear molding seems to be hormonally mediated, the common assertion that breastfeeding may prolong the window of effective intervention remains without convincing evidence. The common auricular anomalies as well as indications, timing, and methodology of effective intervent...
Source: The Surgical Clinics of North America - November 19, 2023 Category: Surgery Authors: Joseph B Vella Source Type: research